Dr. Woodson Says Have The Courage to Intervene for Suicide Prevention

By Dr. Jonathan Woodson, Assistant Secretary of Defense for Health Affairs

September is Suicide Prevention Awareness Month.  The Military Health System has an important role to play in educating the military community and the civilian communities where we live on how to recognize the signs of suicide risk, where to access care and treatment, and how to intervene.

 I don't need to recite the statistics for you. All of you follow the news, and know that action is required to address the incidence of suicide among our Service members and Veterans. Both the Department of Defense and the Department of Veterans Affairs are united in our approach and our outreach.  Earlier this summer  Secretaries Panetta and Shinseki joined our most senior military officers, our top enlisted leaders, and mental health experts for our annual DoD-VA Suicide Prevention Conference where the focus was on getting back to basics.

There are a few important points that have emerged from our research and our experts in the field.  First and foremost, there is no one-size-fits-all solution to eliminate suicide. This is a complex issue with many contributing causes. Yet, there are actions that we can and are taking to ensure everyone is more aware of what can be done.

Leaders, family members, friends and coworkers...the entire military community...MUST be engaged in identifying and helping those at risk.  Many suicidal acts are impulsive. When we can intervene to assist an individual in crisis, we can often prevent the suicide from occurring.

Step one is to get them help. We have made great strides in reducing the perceived stigma of seeking mental health care, but this is just the beginning.  Getting help is a sign of strength, not weakness. It takes more than the medical community to deliver this message, but I am very encouraged by the active engagement in this message from our line leaders, and - more importantly - from our senior enlisted leaders who have such a tremendous influence over our young men and women.

We also better understand how to build up our abilities to manage difficult life challenges, and bounce back from adversity. Each of the Services has introduced resilience training to provide leaders, individuals and family members with the skills to prepare for and manage personal and organizational stressors.

I'm proud too of the role that TRICARE has played in expanding access to critically needed services. Our networks serve an important role in supplementing our direct care system.  For our brothers and sisters in the National Guard and Reserves, who often live far from their units and military installations, this network is a lifeline. As a longtime member of the Army Reserve, I can personally attest to the importance of these services to men and women who live in every state in the nation.

The National Suicide Prevention Hotline (1-800-273-TALK), www.militaryonesource.com, and other resources are readily available.  We need to regularly communicate their value and easy accessibility to our friends and families in need and maybe even more importantly, to those close to someone who may be in need.

Bottom line: The key is recognizing others at risk and in crisis and not being afraid to step in.  Our job as military health care providers, paraprofessionals, and members of the DoD community at large is to have the courage to intervene.

So, we have messaged that there is no shame in seeking help, but how do you overcome the shame and anger you may be met with by taking someone by the hand and doing everything in your power to get them to help if they haven't asked for it?  You run the risk of being wrong and then what?  How can our medical community become a force multiplier in educating the larger community about where to find help for someone else and how do you coax a person on the edge to get help? These are the questions we must continue to address in order to save our comrades, our families, our neighbors, and fellow humans.

Suicide prevention will be a prolonged effort. Awareness and perseverance matter. We can do more, and we are doing more to strengthen our team. To be better prepared, check out our suicide prevention awareness information and resources at Health.mil.  Become the light of hope for someone by helping others learn where to go for help so as a larger DoD family, we can take care of each other!

Panetta, Dempsey Call on Lawmakers to Protect Military Personnel AccountsBy Jim Garamone American Forces Press Service

WASHINGTON  – Calling service members key to U.S. national security, Defense Secretary Leon E. Panetta and Joint Chiefs of Staff Chairman Army Gen. Martin E. Dempsey urged Senators to do right by them and their families.

The secretary and the chairman testified today before the Senate Appropriations Committee’s defense subcommittee. Panetta told lawmakers military personnel are the linchpin to American defense strategy.

“For all the weapons we have, for all the technology we have, frankly, it’s the men and women in uniform that are the strongest weapon we have for the future,” the secretary said. “And so we want to sustain the family assistance programs, the programs for wounded warriors, the basic support programs for our troops and their families.”

Dempsey noted that the government needs to keep faith with service members who have kept faith with the country. “Keeping faith also means appropriate compensation for our troops,” he said. “This budget proposes modest reforms to military pay and benefits. However, it does not place the burden of budget cuts on the shoulders of our men and women in uniform. There are no freezes or reductions in pay. And there is no decrease in the quality of health care received by our active duty members and medically-retired wounded warriors.”

Still, both understand some cost cutting is inevitable and, in some cases, desired. “I’ve got to focus on some savings in the compensation area,” Panetta said. “This is an area that's grown by 90 percent, and frankly, we have got to be able to find some cost constraint in that area.”

The budget calls for military pay raises over the next two years, but for a limit in the out-years.

There needs to be some control on TRICARE health costs as well, he said, given that military health care costs currently run above $50 billion a year.

“We’ve also looked at the idea of a retirement commission to look at retirement provisions for the future,” the secretary said. “We’d like to grandfather, obviously, benefits for those that are presently in the force, but we do need to achieve savings in this area, as well, for the future.”

Dempsey as well told senators the Defense Department needs practical reform to deal with escalating personnel costs. “We must make our health care system more sustainable,” the chairman said. “Otherwise, we risk both the quality and the continuity of care. We can ensure its viability in ways that are fair and modest.”

Military Alcohol Abusers Get Online Help

By Katherine Cruise, Director of Communications and Marketing, Military Pathways/Screening for Mental Health, Inc.

WELLESLEY HILLS, Mass.— The rate of heavy alcohol use among young military men is about twice that of their civilian counterparts. Taking the first step to getting help is as easy as visiting www.DrinkingIQ.org. The anonymous online alcohol screening tool, provided by Military Pathways, is visited by many users during Alcohol Awareness Month in April and on National Alcohol Screening Day, Thursday, April 5.

Military Pathways provides mental health screening tools for the military community. The alcohol assessment, completed by more than 32,500 users, gives service members and their families useful information about their drinking habits. Alcohol assessments provide participants with information and resources if their responses show they could have an alcohol problem.

It also has Video Doctor, an interactive program in which an actor-portrayed doctor guides the user through a series of videos based on the user’s readiness for change. The program assesses the user’s readiness to accept advice, determines what type of help he or she needs, and delivers only what the user is ready to hear. The advice includes tips for seeking help, types of self-care, and ways of cutting down on drinking. Video Doctor is at the cutting edge of online mental health tools and has been very well received by participants.

“It’s important for us on the base to recognize National Alcohol Screening Day to educate military members about screenings and the services available to them that are confidential,” said Lt. Cmdr. Ken Simmet, a U.S. Public Health Service officer serving as the deputy commander, Mental Health Flight, 92nd Medical Group, Fairchild AFB, Wash. “Providing service members with a free, anonymous screening tool allows them to learn more about their own drinking habits,” added Simmet.

Military installations and health care providers around the world are recognizing National Alcohol Screening Day and National Alcohol Awareness Month with events to reach out and educate people about alcohol use and abuse. The program has been extremely well-received since its inception in 1999.

This program helps people realize what kind of relationship they have with alcohol. Research shows that while people who score positive on assessments often seek treatment, many others take steps to reduce their alcohol consumption.

About Military Pathways

 Military Pathways gives service personnel and their families the opportunity to learn more about mental health and alcohol use through anonymous self-assessments offered online. The program is designed to help individuals identify symptoms and access assistance before a problem becomes serious. The self-assessments address alcohol use, PTSD, depression, generalized anxiety disorder, and bipolar disorder. After completing a self-assessment, individuals receive referral information including TRICARE, Military OneSource and Veterans Affairs. The program is run by the nonprofit Screening for Mental Health, Inc. and is fully funded by the Department of Defense, with support from the National Center for Telehealth and Technology (T2). To learn more, visit MilitaryPathways.org.

Pentagon’s Top Doctor Stresses Commitment to Quality Care

By Elaine Sanchez

American Forces Press Service

WASHINGTON, March 29, 2012 – Even in this “belt-tightening era,” Defense Department officials remain committed to sustaining efforts that have led to groundbreaking medical advances in areas such as post-traumatic stress disorder, the Pentagon’s top health affairs official told an audience of behavioral health experts and military leaders here today.

“The leadership of the military health system -- to include the surgeons general of the Army, Navy and Air Force -- have been steadfast that the core mission of medical readiness responsibilities cannot and will not be compromised,” said Dr. Jonathan Woodson, assistant secretary of defense for health affairs and director of the TRICARE Management Activity.

This includes the Pentagon’s investment in medical research and development and in the nature of resilience, he added.

Woodson spoke at the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury’s Warrior Resilience Conference, which is intended to provide service members, units, families and communities with resilience-building techniques and tools.

Defense Secretary Leon E. Panetta and Chairman of the Joint Chiefs of Staff Army Gen. Martin E. Dempsey have made it clear that the department will do its part in the reduction and growth of federal spending, Woodson said, and the health budget is not exempt.

Defense health programs encompass more than $53 billion of DOD’s base budget of $525 billion, the doctor noted. “We really now are at 10 percent of the DOD’s budget,” he said. “We need to make sure those dollars spent are adding value to national defense and to the department.”

Woodson warned against the impact of a possible “sequestration.” Unless Congress agrees on an alternative by January, this provision of the Budget Control Act would trigger an additional $500 billion in across-the-board defense spending cuts over the next 10 years, which Woodson described as a “meat-ax” approach to cutting costs and programs. “We cannot let that happen, and we’re not going to let that happen,” he said.

Woodson said he’s committed to protecting medical research and development programs, which have made great contributions to medical science. “It’s easy in the short term, but painful in the long term to cut research and development budgets,” he said. Instead, he explained, DOD needs to put in place a more “agile” structure that identifies best practices across the services and enables rapid information sharing.

This will save money that can be applied to programs such as research and development, he added.

But just having a program isn’t enough, Woodson said. It must be effective and easily accessible. Nearly 400 programs designed to aid troops and their families are in place, he said, but there’s a lack of metrics to gauge their effectiveness.

“My greatest fear with the meat-ax approach is they’ll cut programs that are truly beneficial … because we don’t have a method of analysis that’s robust,” he said.

Woodson reiterated his commitment to ensuring troops and their families receive the best care possible. “I personally believe we are heading in the right direction on these organizational budgetary decisions,” he said. “We will continue to provide exceptional service to all of those we serve.”

The resources put forth to better understand how to prevent and treat psychological wounds are vital to service members and their families, who have been challenged as never before -- and vital to long-term national security interests, Woodson said. Nearly 11 years of war have “exacted a toll on service members and their families,” he said.

Woodson stressed the importance of leadership and communication in building resilience. “The environment that a leader [creates] in his or her own unit, however small, has an enormously positive affect on resilience,” he said.

This environment, he told the audience, should include the means for open communication. “That reaching out for help when feeling overwhelmed by life’s stressors can help sustain or restore health,” he said. “Seeking help is a sign of strength, and we need to ensure that those who serve know where to turn for help when it’s required.”

Woodson lauded the attendees for taking steps to understand the nature of resilience and to deepen their understanding of psychological issues. Their efforts will be increasingly important as the nation continues to face numerous and complicated” threats, he noted.

“No nation in history has ever put forward more resources, more research and more military leadership attention … to help address and understand how to create and sustain a psychologically healthy force,” Woodson said.

“The importance of your work and efforts … is extraordinarily vital to people who serve,” he added. “It’s vital to extended families and the friends of men and women in uniform, and vital to long-term national security interests.”

Conference to Focus on Building Troops’ Resilience

By Elaine Sanchez

American Forces Press Service

WASHINGTON, March 28, 2012 – Nearly 750 military leaders and psychological health care experts will gather here tomorrow for the Defense Department’s fourth annual Warrior Resilience Conference.

The conference’s intent is to provide service members, units, families and communities with resilience-building techniques and tools that can be used “in garrison or in the field,” explained U.S. Public Health Service Cmdr. George Durgin, resilience division chief for the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, which is hosting the conference.

“Whether a soldier or Marine in the battlefield, a sailor on a ship or an airman on the flightline, the bottom line is be able to have some tools and techniques that will help them overcome an adverse event and be able to continue the mission,” Durgin said. “And if they need help, we’re providing the tools to understand how to reach out and find help -- that it’s OK to seek help or to talk to someone.”

Conference speakers include Chairman of the Joint Chiefs of Staff Army Gen. Martin E. Dempsey, Dr. Jonathan Woodson, assistant secretary of defense for health affairs, and Army Brig. Gen. Bryan Gamble, deputy director of TRICARE Management Activity. The services’ senior enlisted leaders also will be on hand for a panel discussion tomorrow, and a series of breakout sessions will address everything from peer-to-peer support to community outreach.

People who are unable to attend can watch the conference live on the conference’s website at http://warriorstreaming.sessionupload.com. The sessions also will be archived for viewing after the conference, the commander said.

While previous resilience conferences targeted psychological health care providers, this conference focuses on bringing resilience tools and techniques to military leaders, both officer and enlisted, Durgin said, building on last year’s Total Force Fitness theme. This initiative, led by the chairman of the Joint Chiefs of Staff, takes a holistic approach to resilience building, he explained.

Total Force Fitness addresses mind and body and encompasses eight domains: psychological, behavioral, social, physical, environmental, medical, spiritual and nutritional. This conference will focus on the social domain, the commander said, which targets the individual, the family, the community and the unit.

“The social domain … crosses and bridges all of the bonds of the service member,” Durgin said. “It targets the individual connecting to the unit, connecting to the community and connecting to the family.”

They picked this specific domain, he added, “because it has that unique piece of unit. It provides this unique connection that we think is deserving of continuing the education process.”

All of the domains, he added, are “connective pieces” in creating a holistic approach to building service members’ resilience.

Officials focused their efforts on line leaders for this conference, Durgin said, as they recognize Total Force Fitness will be a noncommissioned officer-led initiative.

“The key for this conference is making sure line leaders know there are resources, there’re ways to address issues, to find help and to resolve any adverse events that may occur,” he said.

Durgin pointed out a few of these resources, including the Real Warriors campaign, which seeks to combat the stigma of seeking psychological health care, and the Defense Centers of Excellence round-the-clock helpline.

“There are resources out there that service members can seek anonymously to get help,” he said.